Healthcare Provider Details

I. General information

NPI: 1316857485
Provider Name (Legal Business Name): EHA CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

928 W CHARING CROSS CIR
LAKE MARY FL
32746-6427
US

IV. Provider business mailing address

928 W CHARING CROSS CIR
LAKE MARY FL
32746-6427
US

V. Phone/Fax

Practice location:
  • Phone: 407-330-1374
  • Fax:
Mailing address:
  • Phone: 407-330-1374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. RANDAL PAUL EHA
Title or Position: PRESIDENT
Credential: DC
Phone: 407-330-1374